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Types

Our Approach to Breast Reconstruction

When you are considering breast reconstruction, you may have more options than you realize. Thanks to new advances in reconstructive surgery, many of which we pioneered right here at Stanford, you have the option of choosing how you want to look after breast cancer treatment.

What Is Breast Reconstruction?

Types of Reconstruction Surgery

At Stanford, you have access to the newest developments in reconstruction surgery, some of which were developed by our own nationally renowned surgeons. We go beyond conventional implants and traditional tissue flap procedures to give you results that look and feel more natural.

Nipple-sparing mastectomy

We are improving the success rate of nipple conservation for mastectomies by innovating a new approach that uses advanced imaging technology. The SPY™ imaging system, currently available at only a few breast care centers nationwide, allows our reconstruction specialists to visualize your breast’s unique vascular features before surgery.

Our team then adjusts their approach during surgery according to your blood-flow pattern category. Ultimately, this approach leads to better healing in the nipple area after surgery. This technique also allows for immediate repositioning of your nipple at the time of mastectomy, if you desire it, for a more lifted appearance without additional surgery.

Immediate lumpectomy reconstruction

If your breast has been altered by a lumpectomy procedure, you may have been told nothing can be done to improve your breast’s appearance. At Stanford, we can reconstruct and even enhance one or both breasts on the same day as your lumpectomy. Our incisions are the same as those made in cosmetic surgical procedures.

Post-radiotherapy restoration

After radiation therapy, some people experience an indentation in the breast. If this problem happens to you, we are able to apply a combination of techniques to restore your breast size and shape. By rearranging breast tissue, performing a fat graft, or supplementing with a small implant, we can restore your breast’s original appearance, as well as the symmetry of both breasts.

Implant reconstruction

Traditional implant reconstruction surgery involves the placement of expanders during a mastectomy. These silicone envelopes are gradually filled by our expert plastic surgeons during short, minimally invasive appointments over a series of weeks. This process encourages your skin and soft tissues to heal and stretch until your skin envelope has expanded enough to accept a permanent implant.

This process typically involves expansion appointments every other week until you reach your desired breast size. Then, a second surgery is performed as early as three months later, usually on an outpatient basis so you can go home the same day. If you would prefer to avoid additional appointments and surgeries, you may be able to choose to have a permanent implant placed during your mastectomy.

With either option, you can decide with your surgeon whether to receive a silicone gel-filled or saline-filled implant, as well as what breast size you wish to have. Our goal is to deliver natural-looking results that are as aesthetic as cosmetic breast surgeries. We also offer expert nipple reconstruction with this type of surgery. Our staff is specially trained in a 3-D tattooing technique to achieve the most convincing results available.

Flap reconstruction

The alternative to implant surgery is flap reconstruction surgery. During this procedure, we reconstruct your breast using tissue from another part of your body. Usually, no implant is needed, and your own tissue can provide a more natural look and feel than an implant.

TRAM flap: The TRAM (transverse rectus abdominis myocutaneous) flap is a method of taking tissue from your abdomen, in a procedure similar to a tummy tuck, and moving it to your chest to make a breast. The advantages of this procedure are that it generally does not require an implant and it can simultaneously improve the appearance of your abdominal region.

DIEP flap and SIEA flap: If you are considering having both breasts reconstructed, more tissue from your abdomen can potentially be used for each breast. The use of perforator flaps is a recent, major advance in reconstruction surgery, which leaves all of the abdominal muscle behind. The deep inferior epigastric perforator (DIEP) flap and the superficial inferior epigastric artery (SIEA) flap are examples of flaps that we frequently use. This approach has the advantage of preserving muscle function and minimizing complications in the abdominal area.

SGAP and IGAP flap: The buttock region, based on the blood supply from the superior gluteal artery perforator (SGAP) and inferior gluteal artery perforator (IGAP), can also be used in reconstruction surgery—as well as the thighs or hips. In general, we reserve these other options for when tissue from your abdomen is not available.

LD muscle flap plus implant: If you are not a good candidate for any of the above procedures alone, then we can move tissue from your back to cover an implant. Known as a latissimus dorsi (LD) muscle flap plus implant, this method gives us more tissue to cover any visible silhouette of the implant to achieve a more authentic aesthetic.

Our Clinics

Our breast reconstruction surgeons are strongly committed to excellence in breast reconstruction. If you are considering whether reconstruction surgery is right for you, we are here to help you understand your options and provide information to support your decision-making process.